Smith, Mary Lou

CAMA / - i DREDGE & FILL
GENERAL PERMIT Previous permit #
❑New ❑Modification -iComplete Reissue -]Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
i Rules attached.
Name ' Applicant ` � � = '� ` � Project Location: County
(
Address.`. ; ' -' Street Address/ State Road/ Lot #(s)
- --- - - t:
City ► -- ---- - -- --- -----
Phone # ( }f'( Subdivision -
Authorized AgentCityZIP
Affected ❑ CW ❑ EW fl PTA I] ES ❑ PTS Phone # ( ) River Basin
❑ OEA ❑ HHF ❑ IH ElUBA ❑ N/A
AEC(s): Adj. Wtr. Body nat /man junk--)
❑ PWS: ElFC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: )
Pier (dock) length �,�(� Tt L`t�Y
Platform(s)-
- - -
Finger pier(s)_
Groin length _ -t ---- --
number
-
----
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
�'.Lk
fii
Basin, channel n
_.... ,
- - .LT
-
_
-
cubic yards
i '
Boat ramp -"
�,
-
Boathouse/ Boatlift
- —
Beach Bulldozing
—.
7-1
Other
}
law
Shoreline Length
SAV: not sure yes no
10.
Sandbags: not sure yes no !�
Moratorium: n/a yes no
Photos: yes no10
i
+
Waiver Attached: yes no
A building permit may be required by:
❑ See note
on back regarding River'Badm rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit **
Application Fee(s) Check #
Permit Officer's
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null andvoid.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythat this project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules ❑ Other:
Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-648 [)or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889 .
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

Oct. 3. 2014 9:56AM
No.4077 P. 3
l hereby certify that {own prop adjacent to
property located at O- 9 of Property
(Address, Lot, k, Road c.)
in
(Waterbody) Cltyfrown and/or
N.C.
The applicant has described to me, as shown below, the development proposed at the above
I ratio .
I have no objection to this proposal.
I have objectiona to thls proposal.
13ESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in descdptlon below or attach a site drawing)
r I RECEIVED
�N OCT 07 7�
DCT�I,t�11�S:�TM
WAIVEB SECTION'
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of'.15' from my area of riparian access unless waived by me. (If you
wish -to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
1 do not wish to waive the IS setback requirement.
(Property Owner -information) (Adjacent Property Owner Information)
St a Signatwe . J-•.`-�h-�?�
o UMW
flint or a yp lltame Pdnt or TypA Name
15-9
y 11lL�l� �iee r Crete.
Fyn Add pm �
�Ag C= /`I%Gc�`a�dlj�- C.,a�t. .r�C��•rt_ NC_
a$S8L-
a4 ..-�--
ot
Tefephon9 NW9ber Telephone Number
/a & SL f y -#
Date '"�— — - Date .
(Revised WI&2012)

Oct, 3. 2014 9:56AM No.4077 P. 2
I hereby certify that I own property adjacent to — , ,S
property located at O� ff=P gay Owner}
�� C'R� (Address,/-ot, ock, Road, .)
^---� in N.C.
(Waterbodyj (itylrown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
to �
i have no objection to this proposal.
I have objections to thle proposal.
DESCRIPTION AND1 R DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in'descdptfon below or attach a site drawing)
11,
WAIVER SEC=N, •
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of.15' from my aM of riparian access unless waived by me. (if you
wish- to waive the setback, you must Initiai the appropriate blank below.)
f
I do wish to waive the 15! setback requirement.
. I do not wish to waive the 16 setback requirement.
(Property Owner-lnfbrmati n) (Adjacent Property Owner Information)
t .o fvl 1� *Se
vt l �[.-ea M lb.
Alnt c r i pe ams P►1nt or�Type Na e
(� � k .. _ 6d 7 Veer (�✓e r-%, l r,
M 15ng Addron / Max, Addre
GRYntate/Z52
Telephone Num er !nF;mDaie 'Aate rT
(Revised 8/1&2012)

Oct, 3. 2014
9:56AM
No.4077 P. 1
Pat MoCrary
Governor
NCDENR
North Carolina Department of Environment and Natural Resources
Division of coastal Management
Braxton C. Davis
Director
Dat'.OrG/'i"
Applicant Name
Mailing Address
John E. Skvarla, Ili
Secretary
I certify that I have authorized (agent r (,d,Usi to act on my behalf, for the
purpose of applying for and obtaining all LAMA Permits necessary to install or construct (activity)
at (location)
This certification is valid thru (date)
n
Signature
RECEIVED
OCT 0 7 2014
DCM-MHD CITY
4W Commerce Ave., Morehead City, NC 28557 NOne� ar0j�' S
Phone: [phone]a081 FAX: [phone] Internet_ www.nccoastAmanagementnel
er
M Equal OppoAur�ly t AifirtnaUve ACUon Engioy

GP Habitat Sheet
Name: Mary Lou Smith Permit #: 65246C
Date: 10/7/14 Address: 509 Deer Creek Dr
Habitat
SF of Disturbance
SF of Disturbance
LF of Disturbance
LF of Disturbance
Marsh below nhw
105
105
n/a
n/a
High ground
25
25
n/a
n/a
Open water
205
205
n/a
n/a
shoreline
n/a
n/a
135'
135'
0
RECEIVED
OCT 09'